Provider Demographics
NPI:1538490719
Name:SMITH, DEBRA KAY (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:KAY
Last Name:SMITH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:ONE DELL WAY
Mailing Address - Street 2:MAILSTOP: RR8-49 C/O WELL AT DELL HEALTH CENTER
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78682
Mailing Address - Country:US
Mailing Address - Phone:512-728-9355
Mailing Address - Fax:512-728-6789
Practice Address - Street 1:ONE DELL WAY
Practice Address - Street 2:MAILSTOP RR 8-49 WELL AT DELL HEALTH CENTER
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78682
Practice Address - Country:US
Practice Address - Phone:512-278-9355
Practice Address - Fax:512-728-6789
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA01130363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical